| NPI | 1619048030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 50774) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: RI 6825) |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2026-02-02 |